My Psychologist and Psychiatrist Disagree

Asked by ReallyStruggling on 2018-05-8 with 1 answer:

From the U.S.: Ok, I will so my best to make my situation clear. I have battled with panic disorder (with agoraphobia), and severe generalized anxiety disorder since I was 7 years old (I’m 19). I’ve had two severe major depressive episodes, one of which I am going through right now. I’ve tried a variety of treatments, and am currently NOT on any medication.

I have had some new symptoms lately. I have terrible thoughts of harming my loved ones (specifically my boyfriend and my mother). These thoughts are really vivid, and they are nearly constant. When I have them I fear that I am losing control or that I’m going to go crazy. These thoughts are completely opposite of who I am we a person; I can’t even harm a bug! I have no history of violent behavior. But sometimes I have “urges” to act on these thoughts which makes me panic even more. I don’t know if these are real urges (I don’t want to act on them!) or just adrenaline from my anxiety.

I also recently developed a fear of developing psychosis or schizophrenia. I started obsessing over the possibility of having psychotic symptoms, and spend a lot of my time researching these disorders on the internet. Since I have started doing this, I’ve begun to “hear” voices IN MY HEAD (not external). These “voices” (which aren’t in my own voice BUT I recognize them as my own thoughts) can be commanding, or can be just scary things like laughter. I’ve also started to “have delusions” (which I don think are true delusions because when I have them I panic and think, “why am I thinking like that”). I’ve also started “imagining” that I am seeing things, although I don’t think that I am truly hallucinating. Almost every “symptom” that I am experiencing is something that I’ve read online. I also suffer from racing thoughts, and my mind is NEVER quiet. I constantly have music running through my head as well. Could this be from stress and anxiety?

After discussing my new symptoms with both my psychologist and my psychiatrist, I got two different opinions. My psychologist believes that all of this falls on my anxiety, and might be a form of OCD. My psychiatrist (who I just met for the first time; as I was considering trying medications again), however, diagnosed me with major depressive disorder-severe, recurrent, with psychotic features. The fact that he diagnosed me with a form of psychosis makes me panic even more. Again, my therapist of four years is reluctant to label me “psychotic” as I have full insight to what I am experiencing. She thinks I am obsessing over the potential of losing control and harming others, and obsessing over developing psychosis or schizophrenia.

What is happening to me? Do you think I am psychotic or do you think that this is likely a result of my long-standing, unsuccessfully treated anxiety?

I’m so sorry you are suffering so much. I admire you for being so help-seeking. But in this case, by writing here you are asking the wrong psychologist. You have a therapist who has known you for four years. Please bring your concerns to her and sort them out together. It may be that the psychiatrist saw something she didn’t. Or it may be that there was something about the way you presented yourself in your first time encounter that led to a faulty conclusion. Please stop reading online. It’s only making you more anxious. Trust the therapist you already trust and take it from there.